In certain orthopaedic reconstruction procedures such as a semitendinosus gracilis composite graft procedure, it is necessary to remove a piece of tendon from a patient's knee area. After the tendon has been removed, it is frequently used to replace either the anterior or posterior cruciate ligament. These tendons and ligaments are illustrated in FIG. 1. The semitendinousus gracilis composite graft is illustrated as element 12, and a mid-third patellar tendon graft is illustrated as element 14. The anterior and posterior ligaments are illustrated as elements 16 and 18. Replacement of a ligament with a tendon 20 is illustrated in FIG. 2.
The anterior and posterior ligaments, 16 and 18, are generally much stronger than the tendons that are used to replace these ligaments. Therefore, when a substitute tendon is used, it may be necessary to double, triple, or even quadruple the thickness of a tendon graft to produce a replacement graft having a strength that is similar to the anterior or posterior ligament it is intended to replace. Therefore, in some surgical procedures, after a tendon graft has been harvested, a surgeon will loop the graft and suture opposing lengths 24 and 26 of the graft together as illustrated in FIG. 3. In many surgical procedures, two tendon grafts are looped together to form four strands of tendons which are sutured together.
Generally, it is desirable to suture such strands together on both an upper and a lower side of the strands. Therefore, after a surgeon will typically rotate the strands 180 degrees and suture the under side of the strands together. In the past, a surgeon has performed this procedure of suturing the strands together on a simple table or in mid-air. Since such strands are not under tension when they are sutured together, irregularities in the suturing may occur which can cause an unevenness in the loops. This unevenness may be intensified when the loops are rotated 180 degrees for suturing on the underside.
Therefore, a need existed to provide a device for tensioning such strands in a fixed, looped position to evenly stretch such strands before and during suturing. A need also existed to provide a device which could rotate such strands 180 degrees for suturing on the underside without changing the tension applied to the strands.
Another aspect of the surgical procedures in which tendon grafts are harvested is that the grafts generally need to be scraped prior to suturing or reinsertion into a patient. Generally, a harvested tendon graft will contain a certain amount of "meaty" tissue which needs to be scraped from the surface of the graft. In the past, a harvested graft was typically placed on a sterile cloth or disposable paper towel to scrape this tissue from the graft. One disadvantage of placing the graft on a flexible cloth or towel was that the cloth or towel had a tendency to slip and wrinkle while the graft was being scraped. Therefore, a need existed to provide a rigid, non-skid, sterile surface which could be used for supporting a graft as it is being scraped.
Yet another aspect of such surgical procedures is that after a tendon graft has been scraped and sutured, the graft is generally stored temporarily while the patient is being prepared to receive the graft as an implant. In the past, the graft has been stored in a wet towel or cloth that is wrapped around the graft. The towel is generally soaked in saline solution or other preservative liquid to prevent the graft from drying out while the implantation site in the patient is being prepared. Since the graft is generally totally wrapped up in the towel or cloth, on rare occasions, the graft has been mistakenly thrown away with the towel. Therefore, a need exists to provide a relatively safe and accessible site for storing a tendon graft while a patient is being prepared.
Yet, another aspect of such surgical procedures is that it is commonly necessary to accurately measure the length of a harvested graft, both before and after suturing. In the past, medical personnel have used a separate ruler or other measuring device to measure the length of a graft. The use of a separate measuring device can sometimes be inconvenient in an operating room in which a multitude of surgical instruments are present. It may be difficult for medical personnel to quickly locate a measuring device among the many surgical instruments. Therefore, a need existed to provide a measuring device in close proximity to the location at which a graft would be scraped and sutured.